KERIANN NICKOLA GRAY


Address: 200 Scenery Dr., State College, PA 16801-5602
Phone: 8142314560

KERIANN NICKOLA GRAY (NPI# 1023215670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023215670
Entity Type Individual
Full Name KERIANN NICKOLA GRAY
Credential M.D.
Practice Address 200 Scenery Dr.
State College
PA 16801-5602
Mailing Address 100 N Academy Ave
Danville
PA 17822-4903
Practice Telephone 8142314560
Practice Fax Number 8142316246
Mailing Telephone 5702716144
Enumeration Date 2007-06-28
Last Update Date 2019-08-29
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RH0003X Internal Medicine
Specialization: Hematology & Oncology
246232 NY Allopathic & Osteopathic Physicians
Y 207RH0003X Internal Medicine
Specialization: Hematology & Oncology
MD456589 PA Allopathic & Osteopathic Physicians
N 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Other Provider Identifier

State Issuer Identifier Type Code
PA MEDICARE 464500 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
1 Tallow Wood Dr, Clifton Park, NY 120652807 5182685060
1300 Massachusetts Ave, Troy, NY 121801628 5182685060
317 S Manning Blvd Ste 220, Albany, NY 122083909 5185256418

Office Location

Street Address 200 SCENERY DR.
City STATE COLLEGE
State PA
Zip Code 16801-5602

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811973894 Mary Amanda Jacobs Dermatology 200 Scenery Dr., State College, PA 16801-5602 2005-12-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851880975 Creative Reflections Counseling, LLC Counselor 315 S Allen St Ste 124b, State College, PA 16801 2018-05-03
1679097901 Michelle L Grove Home Health Aide 2100 E College Ave Ste B, State College, PA 16801 2017-07-28
1740702034 Matthew Ishler Counselor 315 S. Allen Street Ste 326, State College, PA 16801 2017-07-09
1699206300 Emily Lauer Specialist/Technologist 102a Multisport Indoor Facility, State College, PA 16801 2017-03-23
1740721075 Luk Devorski Student in an Organized Health Care Education/Training Program Rec Hall University Park, Penn State University, State College, PA 16801 2017-03-20
1013465764 Pennsylvania Cvs Pharmacy LLC Durable Medical Equipment & Medical Supplies 201 West Beaver Avenue, State College, PA 16801 2016-09-12
1740685858 Mallory L. Miller Physician Assistant 100 Radnor Rd Ste 101, State College, PA 16801 2014-10-31
1386053981 Christopher Hippenmeyer Specialist/Technologist 102a East Area Locker Building, Pennsylvania State University, University Park, PA 16801 2014-08-07
1982022059 Christy Sharer Counselor 301 S Allen St Ste 106, State College, PA 16801 2014-04-04
1912250523 Eva M Letwin Counselor 2011 Cato Ave Ste 201, State College, PA 16801 2012-10-19
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Taxonomy Information

Taxonomy Code 207RH0003X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Hematology & Oncology

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1659340818 James V Lieb Internal Medicine 1800 East Park Ave, Lance and Ellen Shaner Cancer Pavilion, State College, PA 16803-6797 2006-03-17
1295056182 Sean Barton O'donnell Internal Medicine 1800 E Park Ave, Lance and Ellen Shaner Cancer Pavilion, State College, PA 16803-6709 2010-06-15
1437129814 Edward P Balaban Internal Medicine 1800 E Park Ave, State College, PA 16803-6709 2006-01-26

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1598372286 Bethanie Jones Internal Medicine 200 St Lukes Ln Ste 100, Stroudsburg, PA 18360-6218 2020-09-26
1053930362 Dubois Regional Medical Center Internal Medicine 88 Hospital Rd, Brookville, PA 15825-1368 2020-04-16
1760947840 Russell Eugene Kaufman Internal Medicine 700 Glengarry Rd, Philadelphia, PA 19118-4111 2019-02-04
1891204921 Ahmed Mostafa Internal Medicine Hahnemann University Hospital, 230 N. Broad St., Philadelphia, PA 19102 2017-09-20
1730607755 Penn State Health Community Medical Group, LLC Internal Medicine 233 College Ave Ste 303, Lancaster, PA 17603-3384 2017-08-30
1831619097 Pinnacle Health Regional Physicians Internal Medicine 233 College Ave Ste 100, Lancaster, PA 17603-3372 2017-06-20
1194193656 Allen Oliff Internal Medicine 1412 Florence Dr, Gwynedd Valley, PA 19437 2015-09-14
1679958912 Lancaster Medical Group, LLC Internal Medicine 1575 Highlands Dr Ste 205, Lititz, PA 17543-7507 2015-07-28
1780077735 Arnon I Dreyfuss Internal Medicine 239 Delancey St, Philadelphia, PA 19106-4318 2015-03-16
1164841193 Maria Vershvovsky Internal Medicine 440 E Marshall St Ste 101, West Chester, PA 19380-5414 2014-04-07
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Competitor

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City STATE COLLEGE
Zip Code 16801

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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